Jorge Kelly Oliva, Moysés Samuel Jorge, Ferreira e Ferreira Efigênia, Ramos-Jorge Maria Letícia, de Araújo Zarzar Patrícia Maria Pereira
Federal University of Minas Gerais, Belo Horizonte, Brazil.
Dent Traumatol. 2009 Apr;25(2):185-9. doi: 10.1111/j.1600-9657.2008.00730.x.
The aims of this study were to assess the epidemiology of traumatic dental injuries (TDI) to primary teeth in infants and toddlers between 1 and 3 years of age and investigate whether TDI was related to biological and social factors. A representative sample of infants and toddlers in the city of Belo Horizonte, Minas Gerais, Brazil (n = 519) was examined during a vaccination campaign. The evaluation of clinical signs of previous dental trauma was performed by nine previously calibrated examiners (intra-examiner Kappa = 0.95%; inter-examiner Kappa = 0.88%). Data were analysed through descriptive analysis, the chi-squared test (P < 0.050) and logistic regression. The prevalence of dental trauma was 41.6%. Among the 519 children examined, 193 (37.2%) had enamel fractures, 30 (5.7%) had enamel-dentin fractures and only three (0.6%) had enamel-dentin fractures involving the pulp. Dental care had been performed within the first 24 h in 4.1% of the sample and after 36 h in 0.8% of the sample. There was no statistically significant difference between genders. The most reported aetiologies were falls (28.8%) and collisions (6.8%). There were no statistically significant associations between the prevalence of dental trauma and non-nutritive sucking habits, dental caries or lip incompetence (P > 0.050). Children of mothers with low levels of schooling (0-6 years of study) had a greater prevalence of TDI (P = 0.001). The results of the logistic regression also demonstrated a significant association between dental injury and the Social Vulnerability Index (P = 0.045). Children from families with high social vulnerability (worse living conditions) had a 1.51 (95% confidence interval 1.0-2.2) greater chance of exhibiting TDI. These results can help guide the implementation of health promotion policies.
本研究的目的是评估1至3岁婴幼儿乳牙创伤性牙损伤(TDI)的流行病学情况,并调查TDI是否与生物学和社会因素相关。在巴西米纳斯吉拉斯州贝洛奥里藏特市的一次疫苗接种活动期间,对一个具有代表性的婴幼儿样本(n = 519)进行了检查。由9名先前经过校准的检查人员对既往牙外伤的临床体征进行评估(检查者内kappa值 = 0.95%;检查者间kappa值 = 0.88%)。通过描述性分析、卡方检验(P < 0.050)和逻辑回归对数据进行分析。牙外伤的患病率为41.6%。在接受检查的519名儿童中,193名(37.2%)有釉质骨折,30名(5.7%)有釉质 - 牙本质骨折,只有3名(0.6%)有涉及牙髓的釉质 - 牙本质骨折。4.1%的样本在伤后24小时内接受了牙科治疗,0.8%的样本在伤后36小时后接受了牙科治疗。性别之间没有统计学上的显著差异。报告最多的病因是跌倒(28.8%)和碰撞(6.8%)。牙外伤患病率与非营养性吸吮习惯、龋齿或唇功能不全之间没有统计学上的显著关联(P > 0.050)。母亲受教育程度低(学习0 - 6年)的儿童TDI患病率更高(P = 0.001)。逻辑回归结果还显示牙损伤与社会脆弱性指数之间存在显著关联(P = 0.045)。来自社会脆弱性高(生活条件较差)家庭的儿童发生TDI的可能性高1.51倍(95%置信区间1.0 - 2.2)。这些结果有助于指导健康促进政策的实施。